The American Health Care Association (AHCA) and the long term care profession remain committed to providing quality long term care and services in our nation’s nursing homes, and to sustaining our longstanding efforts to continually improve the environment in which dedicated employees can better maximize the level of care they give to millions of our nation’s most vulnerable frail, elderly, and disabled citizens.
While AHCA salutes Senators Charles Grassley (R-IA) and Herb Kohl (D-WI) for their career-long commitments to America’s seniors, and appreciate the good intentions reflected in The Nursing Home Transparency and Improvement Act of 2008, AHCA has serious concerns about the legislation in its current form, which was introduced yesterday and which we believe requires substantial modification to achieve the goal we all share—sustaining the quality care improvements being made in America's nursing homes.
AHCA concurs with Senators Grassley and Kohl that consumers need useful, objective, and easily understood information about a facility’s performance to help inform their decisions regarding long term care; however, this kind of publicly-disclosed information must be both up-to-date, accurate, and easy-to-understand for it to be both meaningful for consumers and fair to care providers.
AHCA offers the following recommendations that would better benefit and address the needs of patients, their families, and those who serve them.
- First, the quality of care delivered in facilities should and must be determined by the case-mix of patients and the type and amount of care services they require. The legislation, which seeks to be comprehensive in its approach, fails to address one of the most critical issues facing long term care providers and consumers alike—the severe nurse and caregiver shortage. Without well-trained staff, any health care setting will be limited in its ability to provide quality care. We strongly encourage Congress to examine this caregiver shortage across the health care sector – as recommended in Section 203 of the Long Term Care Quality and Modernization Act.
- Second, we do not believe that the disclosure of financial information—certainly to the degree proposed—will have the intended effect of providing additional useful information for consumers. Such a mandate instead would create yet another administrative burden for long term care facilities, placing paperwork over patient care by inhibiting the investments critical to ensuring the delivery of quality care through medical advances and new technologies.
- Third, according to a recent Government Accountability Office (GAO) study, the Centers for Medicare & Medicaid Services (CMS) currently does not use its authority to enforce government regulations by imposing and collecting Civil Money Penalties (CMPs). Rather than doubling those fines and requiring more immediate payment, as outlined in the new bill, we believe that CMS should be directed to better use its current authority. CMS’ statements to the GAO support this approach since the agency says it hesitates to impose fines higher than $200 per day because increasing those fines could significantly impair or even bankrupt some facilities.
AHCA agrees with Senator Grassley’s statement that acknowledges, “In the nursing home industry, most homes provide quality care on a consistent basis.” We also agree that the system must be fixed, and look forward to working with Senators Grassley and Kohl, and all long term care stakeholders to help improve this bill in a manner that ensures the best interests of our residents and caregivers, and maintains care quality as our paramount objective.
As the nation’s largest association of long term and post-acute care providers, the American Health Care Association (AHCA) advocates for quality care and services for frail, elderly and disabled Americans. Compassionate and caring employees provide essential care to one million individuals in our 11,000 not-for-profit and proprietary member facilities.